Cysts that arise from the teeth, called dentigerous cysts, may be harmless to the tooth but may be the root of certain infections in the head and neck area.
Dentigerous cysts are painless, considered sterile, but may cause facial swelling and delayed tooth eruption. However, head and neck specialists have recently encountered several cases of dentigerous cysts presenting as recurrent head and neck infections or as a deep neck space abscess.
In the study done by researchers from the Upstate Medical University, NY on the topic are to be presented at the 109th Annual Meeting & OTO EXPO of the American Academy of Otolaryngology—Head and Neck Surgery Foundation, being held September 25-28, 2005, at the Los Angeles.
The research findings suggest that of the 327 charts reviewed, seven patients were identified who had dentigerous cysts that presented as head and neck infections. From these seven charts, information was obtained. The researchers recorded the patient's age, abscess/infection site, cyst site, presenting white blood cell (WBC) count, culture results, medical and surgical treatment, and length of hospital stay. These results were then compared to previously reported data for these cysts.
The study concludes that head and neck infections are not the most common presentation of dentigerous cysts. However, the researchers found that 2.1 percent of head and neck infections serious enough to warrant hospital admission at their institution were due to dentigerous cysts, which is more frequent than expected. Therefore, dentigerous cysts need to be considered as a possible underlying cause when treating head and neck infections.
They therefore recommend that unless there is an obvious source of infection, a CT scan should be part of the work up of recurrent head and neck infections as well as those that are serious enough to warrant hospital admission. Definitive treatment of the cyst should follow resolution of the infection. Since these cysts can reoccur, patients should be followed with annual radiologic studies.